Zhang Chenjie, Hao Chunsheng, Niu Zhishang, Song Jinqiu, Qiu Ying, Wang Yalin, Bai Dongsheng
Urology Department, Capital Institute of Pediatrics Children's Hospital, No.2, Yabao Road, Chaoyang District, Beijing, 100020, China.
Inspection Center, Capital Institute of Pediatrics Children's Hospital, Beijing, 100020, China.
Eur J Pediatr. 2025 May 24;184(6):361. doi: 10.1007/s00431-025-06190-w.
This study assessed testicular function in children with cryptorchidism following different orchidopexy procedures by measuring serum anti-Müllerian hormone (AMH). The aim was to identify clinical factors associated with testicular function recovery by comparing pre- and post-operative levels of AMH, luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone (T), and testicular volume at various time points. This prospective observational cohort study included children aged 1 to 1.5 years diagnosed with cryptorchidism via physical examination and ultrasound. The study evaluated testicular function parameters before and after two different orchidopexy techniques, measured at five intervals. Serum AMH was the primary outcome, with FSH, LH, testosterone, and testicular volume as secondary measures. A control group of 57 healthy male infants aged 1 to 2 years was included for comparative analysis. A total of 138 patients were enrolled, with testicular function evaluated preoperatively and at 10 days, 1 month, 3 months, and 6 months post-surgery. Preoperative AMH levels were significantly higher in unilateral compared to bilateral cryptorchidism (P < 0.05). Postoperatively, AMH levels increased by 3 months in children with palpable testicles and by 6 months in those with non-palpable testicles (P < 0.05), with no significant difference between groups at 6 months. Cases with intraperitoneal release procedures also showed significant AMH increases at 3 and 6 months (P < 0.05), and testicular function improved similarly across surgical techniques.
Orchidopexy can pose a risk of injury, emphasizing the need for careful treatment planning. While surgical technique did not significantly affect outcomes in children aged 1 to 1.5 years, serum AMH is a valuable tool for preoperative evaluation and prognosis in cryptorchidism.
•Cryptorchidism impairs testicular function.•Orchidopexy improves function but varies by technique and testicular position.
•AMH is a sensitive postoperative marker for testicular recovery.•Function improvement is consistent across surgical techniques, with intraperitoneal release showing significant AMH gains by 3-6 months.
本研究通过测量血清抗苗勒管激素（AMH），评估不同睾丸固定术治疗隐睾症患儿后的睾丸功能。目的是通过比较术前和术后不同时间点的AMH、黄体生成素（LH）、卵泡刺激素（FSH）、睾酮（T）水平及睾丸体积，确定与睾丸功能恢复相关的临床因素。这项前瞻性观察队列研究纳入了1至1.5岁经体格检查和超声诊断为隐睾症的儿童。该研究评估了两种不同睾丸固定术前后的睾丸功能参数，测量时间间隔为五次。血清AMH是主要观察指标，FSH、LH、睾酮和睾丸体积为次要测量指标。纳入了57名1至2岁健康男婴作为对照组进行对比分析。共纳入138例患者，术前及术后第10天、1个月、3个月和6个月评估睾丸功能。单侧隐睾症患者术前AMH水平显著高于双侧隐睾症患者（P＜0.05）。术后，可触及睾丸的患儿AMH水平在3个月时升高，不可触及睾丸的患儿在6个月时升高（P＜0.05），6个月时两组间无显著差异。采用腹腔内松解术的病例在3个月和6个月时AMH也显著升高（P＜0.05），不同手术技术的睾丸功能改善情况相似。
睾丸固定术可能存在损伤风险，强调需要仔细制定治疗方案。虽然手术技术对1至1.5岁儿童的治疗结果没有显著影响，但血清AMH是隐睾症术前评估和预后的有价值工具。
•隐睾症会损害睾丸功能。•睾丸固定术可改善功能，但因技术和睾丸位置而异。
•AMH是睾丸恢复的敏感术后标志物。•不同手术技术的功能改善情况一致，腹腔内松解术在3至6个月时AMH显著升高。
